| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J7307 |
Etonogestrel implant system |
670 |
670 |
$611K |
| 99213 |
|
5,986 |
5,779 |
$498K |
| 99212 |
|
7,121 |
6,968 |
$476K |
| J3490 |
Drugs unclassified injection |
12,128 |
10,478 |
$452K |
| 99211 |
|
11,776 |
11,573 |
$423K |
| S4993 |
Contraceptive pills for bc |
5,029 |
5,014 |
$421K |
| 99214 |
|
3,095 |
3,030 |
$401K |
| 99202 |
|
2,502 |
2,491 |
$294K |
| 99201 |
|
1,869 |
1,848 |
$162K |
| 99203 |
|
752 |
746 |
$158K |
| J7304 |
Contraceptive hormone patch |
222 |
222 |
$158K |
| 11981 |
|
709 |
709 |
$154K |
| 87806 |
|
6,632 |
5,741 |
$123K |
| S0199 |
Med abortion inc all ex drug |
469 |
466 |
$97K |
| 58300 |
|
721 |
364 |
$59K |
| 11976 |
|
890 |
451 |
$49K |
| 87661 |
|
2,017 |
2,005 |
$47K |
| A4267 |
Male condom |
5,621 |
5,597 |
$39K |
| S9445 |
Pt education noc individ |
1,906 |
1,906 |
$24K |
| 81025 |
|
10,567 |
10,411 |
$24K |
| S5000 |
Prescription drug, generic |
2,998 |
2,726 |
$23K |
| 99204 |
|
100 |
98 |
$22K |
| 76815 |
|
738 |
720 |
$17K |
| J7300 |
Intra copp contra (paragard) |
25 |
25 |
$15K |
| Q0111 |
Wet mounts/ w preparations |
4,966 |
4,866 |
$14K |
| 83986 |
|
6,075 |
5,267 |
$13K |
| S0190 |
Mifepristone, oral, 200 mg |
356 |
354 |
$11K |
| 99000 |
|
4,246 |
4,180 |
$10K |
| 58301 |
|
382 |
198 |
$9K |
| 87491 |
|
3,223 |
3,170 |
$6K |
| Q3014 |
Telehealth facility fee |
136 |
136 |
$2K |
| Q0144 |
Azithromycin dihydrate, oral |
758 |
708 |
$2K |
| 81002 |
|
1,432 |
1,405 |
$2K |
| J8499 |
Oral prescrip drug non chemo |
206 |
140 |
$2K |
| G2012 |
Brief check in by md/qhp |
160 |
159 |
$2K |
| 11982 |
|
51 |
26 |
$1K |
| 87591 |
|
3,160 |
3,109 |
$738.22 |
| S0191 |
Misoprostol, oral, 200 mcg |
475 |
468 |
$646.82 |
| J0696 |
Ceftriaxone sodium injection |
81 |
77 |
$317.44 |
| T1014 |
Telehealth transmit, per min |
133 |
133 |
$315.00 |
| 99401 |
|
12 |
12 |
$228.84 |
| 85018 |
|
268 |
260 |
$181.26 |